Fig. 4.

Autoimmune-like acute hepatitis in a patient on nitrofurantoin.

(A) Severe liver damage with areas of recent bridging necrosis and post-necrotic collapse (H&E, 40×). (B) The hepatic parenchyma shows nodular configuration secondary to post-necrosis collapse, with no obvious established fibrosis or very early collagen deposition (Picrosirius red, 40×). (C) Lobular disarray with multiple necro-inflammatory foci and reactive changes of the liver cell plates with regenerative rosettes (H&E, 200×). (D) Detail of an inflammatory area with clusters of plasma cells (arrowheads), hepatocyte reactive changes with cell ballooning and focal emperipolesis (arrow) (H&E, 400×).